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Owing to serial increases (up to 1310\u2005U\/L) in serum creatine kinase and a history of local intramuscular paliperidone injections for management of schizophrenia, surgical exploration was performed and identified necrotising skeletal muscle inflammation and extensive fat necrosis with an organising abscess, consistent with pyomyositis. A gram stain of purulent fluid revealed gram-positive cocci, but no organisms grew in culture. The patient recovered after 10\u2005days of daptomycin and 7\u2005weeks of wound care. Paliperidone injections were discontinued and oral risperidone was initiated.<\/jats:p>","DOI":"10.1136\/bcr-2015-210017","type":"journal-article","created":{"date-parts":[[2015,6,8]],"date-time":"2015-06-08T06:59:36Z","timestamp":1433746776000},"page":"bcr2015210017","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Necrotising pyomyositis complicating intramuscular antipsychotic administration"],"prefix":"10.1136","volume":"2015","author":[{"given":"Eugene M","family":"Tan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmine R","family":"Marcelin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizwan","family":"Sohail","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kannan","family":"Ramar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,8]]},"reference":[{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.52.8846"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.2","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1177\/106002809502900307","article-title":"Tissue necrosis and necrotizing fasciitis after intramuscular administration of diclofenac","volume":"29","author":"Pillans","year":"1995","journal-title":"Ann Pharmacother"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-004-0039-9"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.4","first-page":"553","article-title":"[Clostridium myonecrosis as a sequelae of intramuscular injections\u2014description of 3 fatal outcomes]","volume":"114","author":"Eckmann","year":"1997","journal-title":"Langenbecks Arch Chir Suppl Kongressbd"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.5","doi-asserted-by":"publisher","DOI":"10.1097\/00063110-200209000-00013"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.6.2866-2869.2004"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-977X(03)00109-3"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2008.00195.x"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.03.031"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(02)00017-X"},{"key":"2025042706300310000_2015.jun08_1.bcr2015210017.11","first-page":"67","article-title":"Nontropical pyomyositis","volume":"35","author":"Larkin","year":"1999","journal-title":"Hosp Physician"}],"updated-by":[{"DOI":"10.1136\/bcr-2015-210017corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2015,7,27]],"date-time":"2015-07-27T00:00:00Z","timestamp":1437955200000}}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-210017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:30:16Z","timestamp":1745746216000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-210017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,8]]},"references-count":11,"alternative-id":["10.1136\/bcr-2015-210017"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-210017","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,8]]}}}